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01/2015 journal articles

DIETARY PATTERNS, NUTRIENT INTAKES, AND NUTRITIONAL AND PHYSICAL ACTIVITY STATUS OF SAUDI OLDER ADULTS: A NARRATIVE REVIEW

H. M. Alsufiani, T.A. Kumosani, D. Ford, J.C. Mathers

J Aging Res Clin Practice 2015;4(1):2-11

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Objective: to review the dietary patterns, nutrient intakes, and nutritional and physical activity status of older adults living in Saudi Arabia, to examine geographical differences in such patterns and to identify research gaps in respect of nutrition and physical activity for this population group. Design: Databases and websites (including Pubmed, Scopus, Proquest, Google Scholar and Arab Center for Nutrition) were searched in English and Arabic languages using the following key words: nutritional status, dietary pattern, food pattern, dietary habits, micronutrient intake and status, macronutrients intake, obesity, malnutrition, iron deficiency anemia, vitamin D, physical activity, exercise, Saudi older adults and Saudi elderly. All relevant and available data for both free-living and institutionalized Saudi older adults (> 50 years old or with mean age > 50 years) published in the last 20 years were included in this review. Results: We found that free-living females consumed fewer meals, and less fruits and vegetables, but their reported energy intake was higher than for males. Low intake of vitamins C and D were common in both genders and in those who lived in western and northern regions while low intake of folate and fiber were common in institutionalized people. Omega-3 fatty acids and fish were more highly consumed by older adults living in the coastal region compared with residents in the internal region. Obesity, overweight, vitamin D deficiency and insufficiency and physical inactivity were prevalent in free living older adults throughout the country while underweight and iron deficiency anemia were prevalent in institutionalized persons. Conclusion: Information on dietary patterns, nutrient intakes, and nutritional and physical activity status of older adults living in Saudi Arabia is fragmentary and interpretation of the findings is hampered by the lack of population-representative sampling frames and the use of heterogeneous data collection tools. More systematic studies are essential to facilitate objective assessment of these important lifestyle-related factors and to inform public health policies.

CITATION:
H. M. Alsufiani ; T.A. Kumosani ; D. Ford ; J.C. Mather (2015): DIETARY PATTERNS, NUTRIENT INTAKES, AND NUTRITIONAL AND PHYSICAL ACTIVITY STATUS OF SAUDI OLDER ADULTS: A NARRATIVE REVIEW. The Journal of Aging Research and Clinical Practice (JARCP). http://dx.doi.org/10.14283/jarcp.2015.46

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VITAMIN D SUPPLEMENTATION AND FUNCTIONAL KNEE OSTEOARTHRITIS PROGRESSION IN OLDER ADULTS WITH OBESITY: DATA FROM THE OSTEOARTHRITIS INITIATIVE

A.J. Zbehlik, L.K. Barre, J.A. Batsis, E.A. Scherer, S.J. Bartels

J Aging Res Clin Practice 2015;4(1):12-15

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Objective: Older adults with obesity are at increased risk of knee osteoarthritis (KOA) and vitamin D deficiency, but data on the effect of vitamin D supplementation in this population are equivocal. This study evaluated the effect of vitamin D supplementation on functional progression of KOA in older adults with obesity. Participants with Body Mass Index ≥30 kg/m2 and aged ≥ 60 years from the Osteoarthritis Initiative progression cohort were stratified by baseline vitamin D use. The relationship between vitamin D supplementation and progression of KOA at 72 months was characterized. The Western Ontario McMaster University Osteoarthritis Index (WOMAC) pain scale was the primary outcome measure. Secondary measures included: WOMAC disability, Physical Activity Scale for the Elderly, gait speed and Knee injury and Osteoarthritis Outcome Score (KOOS) scales. In older adults with KOA and obesity, baseline supplemental vitamin D use did not predict functional progression of osteoarthritis at 72 months.

CITATION:
A.J. Zbehlik ; L.K. Barre ; J.A. Batsis ; E.A. Scherer ; S.J. Bartels (2015): VITAMIN D SUPPLEMENTATION AND FUNCTIONAL KNEE OSTEOARTHRITIS PROGRESSION IN OLDER ADULTS WITH OBESITY: DATA FROM THE OSTEOARTHRITIS INITIATIVE. The Journal of Aging Research and Clinical Practice (JARCP). http://dx.doi.org/10.14283/jarcp.2015.47

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IODINE STATUS NOT ASSOCIATED WITH COGNITIVE FUNCTIONING IN OLDER AUSTRALIANS

L. Buchanan, K.E Charlton, S. Roodenrys, D. Cocuz, T. Pendergast, G. Ma

J Aging Res Clin Practice 2015;4(1):16-24

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Objective: This study aims to investigate whether iodine status is associated with cognitive functioning and mood state in a sample of healthy older Australians. Design: Cross-sectional study. Setting: Illawarra region of New South Wales, Australia. Participants: Eighty-four men and women (25 males; 59 females) aged 60-95 years with normal cognitive function. Measurements: Three repeated fasting urine samples were collected a week apart to assess median urinary iodine concentration for the group. Usual dietary iodine intake was measured using an iodine-specific food frequency questionnaire and three repeated 24-hour dietary recalls while nutritional status was assessed using the Mini Nutritional Assessment (MNA). Cognitive function was assessed by the CogState battery of tests and the Rey Auditory Verbal Learning Task (RAVLT) and mood state determined by the Geriatric Depression Scale (GDS). Associations between iodine status and cognitive tests were assessed by Wilcoxon signed-rank, Pearson, and Spearman rank correlation tests. Results: Median urinary iodine concentration (MUIC) indicated mild iodine deficiency (71μg/L; IQR = 55 – 102 μg/L). Iodine status was not significantly associated with any domains of cognitive function. Memory was negatively correlated with mood state (r = -0.375; P<0.05) and positively associated with nutritional status (r = 0.235; P<0.05). Conclusion: Iodine status is not associated with cognitive functioning in a sample of older people with mild iodine deficiency. It remains to be seen whether correction of more severe iodine deficiency in this age group would have a beneficial impact on domains of attention, visuospatial processing, and executive processing.

CITATION:
L. Buchanan ; K.E Charlton ; S. Roodenrys ; D. Cocuz ; T. Pendergast ; G. Ma (2015): Iodine status not associated with cognitive functioning in older Australians. The Journal of Aging Research and Clinical Practice (JARCP). http://dx.doi.org/10.14283/jarcp.2015.42

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DEVELOPMENT OF AN INTEGRATED SCREENER FOR UNDERNUTRITION WITHIN A COMPREHENSIVE GERIATRIC ASSESSMENT SYSTEM

O.R.L. Wright, K. Klein, P. Lakhan, A.P. Vivanti, L.C. Gray

J Aging Res Clin Practice 2015;4(1):25-33

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Objective: To develop a screener for the presence of undernutrition in older adults in acute care utilizing items within a comprehensive geriatric assessment (CGA) instrument (the interRAI Acute Care). Design: Prospective cohort study and retrospective medical record review of nutritional assessment data. Setting: Acute care tertiary teaching hospital in Brisbane, Australia. Participants: Five hundred fifty-seven general medical patients aged 70 and older admitted to the hospital. Measurements: Prevalence of geriatric syndromes at admission; measures of functional status (activities of daily living), cognition, behavioural symptoms, social support, community assistance services, health conditions, medications and other medical treatments, weight, body mass index (BMI), mode of nutritional intake; demographic variables and Subjective Global Assessment (SGA) of nutritional status. These measures were tested for their prediction of undernutrition using a logistic regression model and decision tree analysis. Results: The following variables were significant independent predictors of undernutrition on admission, after adjustment for age and gender: (i) feeling sad/depressed (OR: 3.494 [1.124-10.864]; p<0.05); (ii) short term memory recalling ability (OR: 3.325 [1.152-9.594]; p<0.05); (iii) weight loss of 5% or more in the last 30 days or 10% or more in the last 180 days (OR: 2.877 [0.983-8.416]; p=0.05); (iv) fatigue (OR: 3.494 [1.414-43.205]; p<0.05). Decision tree analysis revealed two models most predictive of undernutrition: (i) short term memory recalling ability and depression (AUC 72.8% [95% CI: 65%-80.6%]); (ii) short term memory recalling ability and recent weight loss (5% or more in the last 30 days or 10% or more in the last 180 days) (AUC: 74.8% [95% CI: 65.9% - 83.6%]). Conclusion: Several measures within the interRAI-AC may be used as part of a screener for undernutrition in acute hospital patients aged 70 years or older. The combination of short term memory recalling ability and percentage weight loss provides the most statistically robust screener for undernutrition within the interRAI-AC.

CITATION:
O.R.L. Wright ; K. Klein ; P. Lakhan ; A.P. Vivanti ; L.C. Gray (2015): DEVELOPMENT OF AN INTEGRATED SCREENER FOR UNDERNUTRITION WITHIN A COMPREHENSIVE GERIATRIC ASSESSMENT SYSTEM. The Journal of Aging Research and Clinical Practice (JARCP). http://dx.doi.org/10.14283/jarcp.2015.48

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ASSOCIATION BETWEEN ANEMIA, PHYSICAL PERFORMANCE, DEPENDENCY, AND MORTALITY IN OLDER ADULTS IN THE NORTH-WEST REGION OF RUSSIA

A. Turusheva, E. Frolova, E. Korystina, D. Zelenukha, P. Tadjibaev, N. Gurina, J.M. Degryse

J Aging Res Clin Practice 2015;4(1):34-43

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Objective: To assess the prevalence of anemia and its impact on physical performance, dependency, and mortality in older adults in the north-west region of Russia. Design: A population-based prospective cohort study. Setting: A random sample of the population living in the Kolpino District. Participants: A total of 611 community-dwelling individuals aged 65 years and older. Measurements: Hemoglobin, gender, age, comorbidity, creatinine, C-reactive protein, body mass index, the Mini Nutritional Assessment, the Short Physical Performance Battery, grip strength, the Barthel Index, the Mini-Mental State Examination, and the 15-item Geriatric Depression Scale were measured/administered. A second screening was organized after 33.4±3 months. The total observation time was 47 ± 14.6 months. Results: The prevalence of anemia was higher in men (21.4%) than in women (18.6%). After adjustment for age, gender, nutritional status, creatinine levels, mental impairment, and various comorbid conditions, significant associations were found between anemia and dependency [OR(95% СI) = 1.798 (1.068 – 3.029); p = 0.027], lower physical performance [ β(95%CI) = -0.717 (-1,334 – -0.100); p = 0.023], and greater risk of mortality [HR (95%CI) = 1.871 (1.284 – -2.728); p = 0.001]. Participants with anemia and CRP levels > 5 had a higher risk of mortality compared with anemic participants with lower CRP levels [HR (95%CI) = 3.417 (1.869 – 6.245); p = 0.000]. Conclusion: The estimated prevalence of anemia in the population aged 65 years and older is 19.3% (95%CI = 15.99 – 23.13). Anemia is associated with poor physical performance and dependency and is an independent predictor of mortality in older individuals.

CITATION:
A. Turusheva ; E. Frolova ; E. Korystina ; D. Zelenukha ; P. Tadjibaev ; N. Gurina ; J.M. Degryse (2015): ASSOCIATION BETWEEN ANEMIA, PHYSICAL PERFORMANCE, DEPENDENCY, AND MORTALITY IN OLDER ADULTS IN THE NORTH-WEST REGION OF RUSSIA. The Journal of Aging Research and Clinical Practice (JARCP). http://dx.doi.org/10.14283/jarcp.2015.44

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AN OVERVIEW ON ASSESSMENT TESTS FOR ALZHEIMER’S DISEASE IN MEXICO. THE NATIONAL DEMENTIA SURVEY: A STUDY FROM THE MEXICAN GROUP OF SPECIALISTS IN DEMENTIAS

S.P. Ramírez Díaz, G.Albert Meza, R.E. Albrecht Junghanns, I.C. Zúñiga Gil, M.A. Bedia Reyes, L.A. Barba Valadez, E. Almanza Huante

J Aging Res Clin Practice 2015;4(1):44-49

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Objective: To know the current status of the clinical assessment tests used to evaluate Alzheimer’s disease (AD) and memory-related dementias in specific regions throughout Mexico. Design, patients and settings: Patients with objective memory impairment were subjected to a clinical survey in medical centers specializing in memory loss. Each patient’s consultation was conducted like a routine clinical practice. Patient’s data were recorded using an anonymous patient survey. The most prominent behavioral problems were recorded. Results: 1350 patients were tested, 65.19% female (n=880). Out of 1350 patients, 76.59% (n=1034) had been previously diagnosed with any kind of dementia. The most common diagnosis concerning cognitive impairment was AD (54.2%, n=560) and Vascular Dementia (VaD, 19.7%, n=204). Minimental State Examination (MMSE) was performed in all patients and the average score was of 18±7. Katz scale for Activities of Daily Living (ADL) was performed in 49.41% (n=667) of patients, Lawton and Brody scale for Instrumental activities of daily living (IADL) in 35.78% (n=483), and Geriatric Depression Scale (GDS-Yesavage) in 32.89% (n=444). The most prominent behavioral symptom was apathy (12.15%, n=164).The most frequent concomitant diseases were: high blood pressure in 52.3%, diabetes in 27.0% and Dyslipidemia in 23.4%. Conclusions: Through the assessment of clinical surveys throughout Mexico, it was found that the most common form of dementia is AD and it is followed by VaD. Commonly, the Katz, Lawton and Brody, and the GDS-Yesavage scales are clinical assessment tests that are the most commonly used. There are many differences in the use of tests to evaluate patients with dementia across Mexico. For the first time, we were able to identify tendencies in the assessment of dementias by Mexican physicians.

CITATION:
S.P. Ramírez Díaz ; G.Albert Meza ; R.E. Albrecht Junghanns ; I.C. Zúñiga Gil ; M.A. Bedia Reyes ; L.A. Barba Valadez ; E. Almanza Huante ; Mexican Group of Specialists in Dementias (2015): AN OVERVIEW ON ASSESSMENT TESTS FOR ALZHEIMER’S DISEASE IN MEXICO. THE NATIONAL DEMENTIA SURVEY: A STUDY FROM THE MEXICAN GROUP OF SPECIALISTS IN DEMENTIAS. The Journal of Aging Research and Clinical Practice (JARCP). http://dx.doi.org/10.14283/jarcp.2015.49

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THE IMPACT OF DENTURES ON THE NUTRITIONAL HEALTH OF THE ELDERLY

M. Cafaro Gellar, D. Alter

J Aging Res Clin Practice 2015;4(1):50-53

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Objective: There are many factors that can affect appetite in the older adult. Physiological factors affecting appetite can include cardiovascular disease, pulmonary disease, renal disease, mental health issues, and even side effects of medications. Decreased ability to ambulate due to joint issues or pain can also negatively impact an older adult’s appetite. But perhaps one significant factor that is commonly overlooked is the ill fitting partial or complete denture. According to the American Dental Association, there are approximately 57% of people ages 65 to 74 wearing some form of denture. Due to this large number of denture wearers, it becomes imperative that health care providers learn to incorporate an oral assessment into their plan of care each time an older adult patient is examined. This assessment can assist providers to identify and differentiate unintentional weight loss and loss of appetite as being either part of a disease process or as a symptom of denture issues. Only then can the overall health of the elderly be holistically viewed and treated. The aim of this paper is to provide a summary of published data expressing the nutritional issues that occur in the elderly due to either being edentulous or from wearing improperly fitting dentures.

CITATION:
M. Cafaro Gellar ; D. Alter (2015): THE IMPACT OF DENTURES ON THE NUTRITIONAL HEALTH OF THE ELDERLY. The Journal of Aging Research and Clinical Practice (JARCP). http://dx.doi.org/10.14283/jarcp.2015.45

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OSTEOPOROSIS IN THE COMMUNITY: FINDINGS FROM A NOVEL COMPUTERIZED REGISTRY IN A LARGE HEALTH ORGANIZATION IN ISRAEL

I. Goldshtein, J. Chandler, V. Shalev, S. Ish –Shalom, A.M. Nguyen, V. Rouach, G. Chodick

J Aging Res Clin Practice 2015;4(1):59-65

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Background: Osteoporosis is a growing public health concern due to its rising prevalence and excess morbidity and mortality. Automated patient registries have gained great importance in health and disease management of major chronic diseases, but are rarely used in osteoporosis. Objectives: To construct an automated, population-based registry of osteoporosis. Setting: The electronic medical records and pharmacy databases of a 2 million member health organization in Israel (Maccabi Healthcare Services). Methods: Included in the registry were adults who were diagnosed with osteoporosis diagnosis, had major osteoporotic fractures, or purchased relevant medications, between 2000 and 2013. In addition, we included patients with low bone density as extracted from over 140,000 measurements reports, using an automated optical character recognition (OCR) system. Two-thirds of the cases were validated by more than one inclusion criterion. Results: A total of 118,141 osteoporosis patients were identified. The point prevalence of osteoporosis among members aged 50 or above in 2013 was 19%. The mean age at registry entry was 62 (SD=12) and 66 (SD=14) years for females and males, respectively. The highest annual risk of developing osteoporosis (27 per 1000) was recorded among females aged 65-75. In 28% of the patients, there was no indication of treatment with osteoporosis therapy. Conclusions: To the best of our knowledge, this is one of the first real-world automated registries of osteoporosis. Similar registries may provide valuable data for real-time monitoring of trends, quality of care, and outcome research in osteoporosis and its complications.

CITATION:
I. Goldshtein ; J. Chandler ; V. Shalev ; S. Ish –Shalom ; A.M. Nguyen ; V. Rouach ; G. Chodick ; (2015): OSTEOPOROSIS IN THE COMMUNITY: FINDINGS FROM A NOVEL COMPUTERIZED REGISTRY IN A LARGE HEALTH ORGANIZATION IN ISRAEL. The Journal of Aging Research and Clinical Practice (JARCP). http://dx.doi.org/10.14283/jarcp.2015.43

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BODY COMPOSITION AND HAND GRIP STRENGTH IN HEALTHY COMMUNITY-DWELLING OLDER ADULTS IN SWEDEN

A. Lindblad, S. Dahlin-Ivanoff, I. Bosaeus, E. Rothenberg

J Aging Res Clin Practice 2015;4(1):154-58

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Background: Longevity increases worldwide but there are few studies on body composition and hand grip strength in populations over 80 years. Given high prevalence of chronic disease and functional disability in octogenarians, it may be difficult to distinguish effects of ageing from those imposed by disease. The European Consensus definition of sarcopenia recommends using both low muscle mass and function for diagnosis. Objectives: Examine body composition and hand grip strength in a selected group of community-dwelling older adults with high level of functional independence. In addition, longitudinal changes in handgrip strength were examined using previously collected data. Design: Cross-sectional body composition and hand grip strength with a four year retrospective analysis on previously assessed hand grip strength. Setting: Measurements were conducted by home visits. Participants: 102 community-dwelling 83-96 year-olds, 50 % women. Measurements: Hand grip strength was registered by a dynamometer and body composition analysis using bioimpedance spectroscopy. Results: According to European Consensus definition, only 6/102 had normal muscle mass - no men, although 78 % of men and 40 % of women had normal muscle strength. Since previously collected data four years earlier, men had lost strength (p<0.001), while women had not (p=0.202). Conclusions: Subject characteristics and health status support well-preserved body energy, protein stores and muscle strength. Low muscle mass was much more prevalent than low muscle strength. Results may give an indication of what constitutes a healthy body composition in oldest old and could serve as a starting point for reference values on healthy body composition in octogenarians.

CITATION:
A. Lindblad ; S. Dahlin-Ivanoff ; I. Bosaeus ; E. Rothenberg (2015): BODY COMPOSITION AND HAND GRIP STRENGTH IN HEALTHY COMMUNITY-DWELLING OLDER ADULTS IN SWEDEN. The Journal of Aging Research and Clinical Practice (JARCP). http://dx.doi.org/10.14283/jarcp.2015.50

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NUTRIENT INTAKE AND NUTRITIONAL STATUS OF THE AGED IN LOW INCOME AREAS OF SOUTHWEST, NIGERIA

W.A.O. Afolabi, I.O. Olayiwola, S.A. Sanni, O. Oyawoye

J Aging Res Clin Practice 2015;4(1):66-72

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Objective: The study was carried out to assess the nutrient intake and nutritional status of free living and non-institutionalized elderly Nigerian men and women residing in low income areas. Design, Setting and Participants: The study was cross sectional involving 140 (58-99 years) apparently healthy elderly subjects randomly selected across four low income urban and rural areas of southwest Nigeria. Measurements: Data on socio economic characteristics and dietary intake (24-hour recall) were obtained with a structured questionnaire while anthropometric data were measured and nutritional status indices were classified using WHO standards. Nutrient intake data was compared to DRI while other data were analyzed using Statistical Package for Social Sciences version 16.0. Results: Majority (84.3%) of the respondents were married and illiterate (80%). Most popular occupation were farming (47%) and trading (35.7%). Half of the respondents earn ≤ NGN1, 000 (≤US$6) and only 27% earn ≥ N6000 (US$37) monthly. The mean weight, height and arm circumference for men were 59.7 ± 6.50kg, 1.61±10.564m and 27.5 ± 9.24 cm respectively while that for women were 56.3 ± 5.72 kg, 1.57 ± 4.37m and 27.0 ± 5.22cm respectively. The mean daily energy (1805.2Kcal) and protein (23g) intake of women were significantly (p<0.05) lower than that of men (2044Kcal and 27.7g respectively). Intake of protein, calcium, riboflavin, niacin and vitamin C for both men and women were below DRI while iron, phosphorus, thiamine and energy intakes were adequate. Prevalence of underweight was low (2.9%) in this study while that overweight (pre obesity) was high (20% for men and 22.8% for women). Weight and BMI are significantly influenced by energy intake of the men (r=0.439, p=0.008); (r=0.352,p=0.038) and not women (r=0.229,p=0.186; r=0.320,p=0.06 respectively) while arm circumference was significantly (p<0.05) influenced by protein intake of both men and women (r=0.333,p=0.04 and r=0.404,p=0.02) respectively. Conclusion: This study has established a less than adequate intake of protein and some micronutrients among the elderly population as well as a high prevalence of overweight which coexists with underweight. There is need for a functional policy on the care of the aged in Nigeria in order to improve their nutrition, health and general wellbeing.

CITATION:
W.A.O. Afolabi ; I.O. Olayiwola ; S.A. Sanni ; O. Oyawoye (2015): NUTRIENT INTAKE AND NUTRITIONAL STATUS OF THE AGED IN LOW INCOME AREAS OF SOUTHWEST, NIGERIA. The Journal of Aging Research and Clinical Practice (JARCP). http://dx.doi.org/10.14283/jarcp.2015.51

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